CAJ | 학술논문

目的观察不同强度超声辐照结合超声造影干预对比格犬左心室心肌力学状态的影响,量化评价超声辐照诱导的左心室跨壁心肌力学变化特征.方法 12只健康比格犬开胸模型,随机分为A、B两组各6只.A组:诊断型超声探头输出声能3～300 MW,采集超声辐照5 min、注射造影剂后辐照5 min和注射造影剂后20 min左心室短轴二尖瓣水平、乳头肌水平、心尖水平3个完整心动周期实时灰阶图像;B组:治疗型超声探头输出声能分别为1W、2W、3W,分别采集经超声辐照5 min后左心室短轴二尖瓣水平、乳头肌水平、心尖水平3个完整心动周期实时灰阶图像.应用Syngo图像工作站,分别获取3个短轴切面共18个节段前间隔、前壁、侧壁、后壁、下壁、后间隔的心内膜下心肌和心外膜下心肌周向应变的时间变化曲线并测量其峰值和达峰时间.评价不同干预状态比格犬左心室心肌峰值周向应变及其达峰时间相关力学参数变化.结果 ①A组超声辐照5 min、注射造影剂后辐照5 min、20 min心内膜下心肌和心外膜下心肌峰值周向应变与基础状态比较均有增大的趋势,大多数节段比较差异有统计学意义(P＜0.05);B组超声输出声能1W与基础状态比较心内膜下心肌呈增大趋势,其中4个节段差异有统计学意义(P＜0.05);超声输出声能2W、3W与基础状态比较心内膜下心肌呈逐渐下降趋势,部分节段比较差异有统计学意义(P＜0.05).②A组、B组相同状态相同节段心内膜下心肌和心外膜下心肌峰值周向应变的达峰时间少部分节段差异有统计学意义(P＜0.05);B组不同状态同一节段心内膜下和心外膜下心肌峰值周向应变的达峰时间有统计学差异的节段比较A组增多.结论单纯诊断剂量超声辐照、诊断剂量超声辐照结合超声造影微泡干预以及治疗剂量超声辐照输出声能1W时可诱导左心室心肌周向应变增大,适当剂量超声辐照对左心室心肌具有正性肌力作用;超声辐照输出声能2W、3W时诱导在体比格犬左心室心肌周向应变下降和达峰时间延迟,推测较大剂量超声辐照对左心室心肌机械功能可能存在损伤. 目的觀察不同彊度超聲輻照結閤超聲造影榦預對比格犬左心室心肌力學狀態的影響,量化評價超聲輻照誘導的左心室跨壁心肌力學變化特徵.方法 12隻健康比格犬開胸模型,隨機分為A、B兩組各6隻.A組:診斷型超聲探頭輸齣聲能3～300 MW,採集超聲輻照5 min、註射造影劑後輻照5 min和註射造影劑後20 min左心室短軸二尖瓣水平、乳頭肌水平、心尖水平3箇完整心動週期實時灰階圖像;B組:治療型超聲探頭輸齣聲能分彆為1W、2W、3W,分彆採集經超聲輻照5 min後左心室短軸二尖瓣水平、乳頭肌水平、心尖水平3箇完整心動週期實時灰階圖像.應用Syngo圖像工作站,分彆穫取3箇短軸切麵共18箇節段前間隔、前壁、側壁、後壁、下壁、後間隔的心內膜下心肌和心外膜下心肌週嚮應變的時間變化麯線併測量其峰值和達峰時間.評價不同榦預狀態比格犬左心室心肌峰值週嚮應變及其達峰時間相關力學參數變化.結果 ①A組超聲輻照5 min、註射造影劑後輻照5 min、20 min心內膜下心肌和心外膜下心肌峰值週嚮應變與基礎狀態比較均有增大的趨勢,大多數節段比較差異有統計學意義(P＜0.05);B組超聲輸齣聲能1W與基礎狀態比較心內膜下心肌呈增大趨勢,其中4箇節段差異有統計學意義(P＜0.05);超聲輸齣聲能2W、3W與基礎狀態比較心內膜下心肌呈逐漸下降趨勢,部分節段比較差異有統計學意義(P＜0.05).②A組、B組相同狀態相同節段心內膜下心肌和心外膜下心肌峰值週嚮應變的達峰時間少部分節段差異有統計學意義(P＜0.05);B組不同狀態同一節段心內膜下和心外膜下心肌峰值週嚮應變的達峰時間有統計學差異的節段比較A組增多.結論單純診斷劑量超聲輻照、診斷劑量超聲輻照結閤超聲造影微泡榦預以及治療劑量超聲輻照輸齣聲能1W時可誘導左心室心肌週嚮應變增大,適噹劑量超聲輻照對左心室心肌具有正性肌力作用;超聲輻照輸齣聲能2W、3W時誘導在體比格犬左心室心肌週嚮應變下降和達峰時間延遲,推測較大劑量超聲輻照對左心室心肌機械功能可能存在損傷.
목적 관찰불동강도초성복조결합초성조영간예대비격견좌심실심기역학상태적영향,양화평개초성복조유도적좌심실과벽심기역학변화특정.방법 12지건강비격견개흉모형,수궤분위A、B량조각6지.A조:진단형초성탐두수출성능3～300 MW,채집초성복조5 min、주사조영제후복조5 min화주사조영제후20 min좌심실단축이첨판수평、유두기수평、심첨수평3개완정심동주기실시회계도상;B조:치료형초성탐두수출성능분별위1W、2W、3W,분별채집경초성복조5 min후좌심실단축이첨판수평、유두기수평、심첨수평3개완정심동주기실시회계도상.응용Syngo도상공작참,분별획취3개단축절면공18개절단전간격、전벽、측벽、후벽、하벽、후간격적심내막하심기화심외막하심기주향응변적시간변화곡선병측량기봉치화체봉시간.평개불동간예상태비격견좌심실심기봉치주향응변급기체봉시간상관역학삼수변화.결과 ①A조초성복조5 min、주사조영제후복조5 min、20 min심내막하심기화심외막하심기봉치주향응변여기출상태비교균유증대적추세,대다수절단비교차이유통계학의의(P＜0.05);B조초성수출성능1W여기출상태비교심내막하심기정증대추세,기중4개절단차이유통계학의의(P＜0.05);초성수출성능2W、3W여기출상태비교심내막하심기정축점하강추세,부분절단비교차이유통계학의의(P＜0.05).②A조、B조상동상태상동절단심내막하심기화심외막하심기봉치주향응변적체봉시간소부분절단차이유통계학의의(P＜0.05);B조불동상태동일절단심내막하화심외막하심기봉치주향응변적체봉시간유통계학차이적절단비교A조증다.결론 단순진단제량초성복조、진단제량초성복조결합초성조영미포간예이급치료제량초성복조수출성능1W시가유도좌심실심기주향응변증대,괄당제량초성복조대좌심실심기구유정성기력작용;초성복조수출성능2W、3W시유도재체비격견좌심실심기주향응변하강화체봉시간연지,추측교대제량초성복조대좌심실심기궤계공능가능존재손상.
Objective To evaluate the changes of segmental and the transmural myocardial peak circumferential strain (CS) of left ventricular(LV) wall with ultrasound irradiation and conbined with ultrasound contrast agent.To provide a reliable database to optimize mechanical effect of LV myocardium.To determine whether diagnostic and therapeutic dosage of ultrasound irradiation or combined with ultrasound contrast agent could induce a positive inotropic action on LV myocardium.Methods The standard short-axis gray scale views at levels of mitral annulus (MV),papillary muscle (PW) and apex (AP)during three complete cardiac cycles in open-chest Beagle canine models were acquired.The beagles were assigned into two groups randomly,group A (n =6) for baseline,baseline low dose ultrasound irradiate(3～300 mW) 5 min,combined with contrast agent 5 min and 20 min conditions,group B (n =6) for high dose ultrasound irradiation(1 W,2 W and 3 W)conditions.The CS and time to peak of CS at 18 segments and its subendomyocardium (subendo) and subepimyocardium (subepi) of LV myocardium were measured and analyzed using a dedicated Syngo VVI workstation.Results ①The CS was increased significantly (P ＜ 0.05) on different conditions of ultrasound irradiation in group A compared with CS on baseline condition at the most myocardial segments of LV under different conditions.The CS at four myocardial segments of LV was increased significantly (P ＜0.05) with 1 W ultrasound irradiation dose in group B compared with CS on baseline condition.In group B,2 W and 3 W ultrasound irradiation doses induced a siginificant decreased CS (P ＜0.05) compared with CS on baseline condition at the most myocardial segments of LV.② The difference of time to peak of CS at subendo and subepi of a few segments under different irradiation conditions was demonstrated (P ＜0.05) in the same group.Difference of time to peak of CS of subendo and subepi at the same myocardial segments in group B was bigger than those in group A.Conclusions The CS of LV was increased significantly under low dose ultrasound irradiation and combined with ultrasound contrast agent and decreased under high dose ultrasound irradiation.These findings might indicate a potential positive and negetive inotropic effects on LV myocardial deformation could be induced using ultrasound irradiation.